Medical Care

Many Americans know to associate fever with illness. But healthcare professionals know that, when it comes to diabetes, every part of a patient’s body, from their hair to their toes, can aid in diagnosis.

Eight percent of the U.S. population has diabetes, but nearly six million people remain undiagnosed. According to the American Podiatric Medical Association (APMA), foot problems can help doctors discover diabetes. Diabetes can cause nerve damage in people’s feet, which can easily lead to amputation.

In the U.S., more than 60 percent of the patients who receive non-traumatic lower-limb amputations have diabetes. In 2004, almost 71,000 American diabetics needed amputations. Luckily, most diabetic amputations can be prevented through vigilant footcare.

”Diabetes can cause patients to lose sensation in their extremities, therefore a person with diabetes might not notice injuries to their feet until serious infection occurs,” said Ross Taubman, D.P.M., president of APMA. ”In most cases, patients can avoid amputation by working regularly with a podiatrist.”

Once diagnosed, patients with diabetes can prevent amputation by creating a footcare plan. Plans should include annual checkups with a podiatrist and daily foot inspections. Diagnosed diabetics need to be especially careful about footcare and should work with a podiatrist to determine the best preventative treatments.

Early diagnosis helps prevent severe nerve damage. For patients at risk for developing diabetes, foot conditions can be an early warning sign. According to the APMA, patients should see a podiatrist if they notice the following conditions:

• Calluses, blisters, or dry and cracked skin anywhere on the foot can imply poor circulation or foot health, especially if you don’t feel them or they take two or more weeks to heal.
• Look for thin, fragile, shiny or hairless skin, which can denote decreased circulation to the foot.
• Check shoes for torn linings or foreign objects. If they don’t irritate you when you walk, you might have nerve damage. Other warning signs include foot deformities like hammertoes, a past history of foot ulcers, or lower leg or thigh pain when walking.

For more information on preventing diabetes complications to the feet, visit the APMA’s website at www.apma.org.

The Wall Street Journal reports: As Urgent Care Grows, Watchdogs Circle

The number of emergency rooms has been falling in recent years, as the number of people heading into the ER has been climbing.

Urgent care centers — doc-in-a-box outfits that handle urgent health problems that aren’t life-threatening — have been growing to take up some of the slack.

But, this morning’s WSJ notes, urgent care has remained largely unregulated. Urgent care doctors and nurses do have to be licensed the same as health care providers anywhere else, but there are no national standards for what urgent care centers should offer, or what quality measures they should meet.

That looks likely to change. The Urgent Care Association of America recently made a deal with the Joint Commission, the group that accredits the nation’s hospitals, to accredit urgent care centers and publish national quality standards by 2010.

While many insurers already pay for some urgent care services, accreditation could lead to better reimbursements. “We’d look far more favorably at an urgent-care clinic that was accredited than one that wasn’t,” Troy Brennan, chief medical officer at Aetna, tells the WSJ. “[I]t means an organization is taking a hard look at a variety of safety issues that should be involved in caring for someone who is acutely ill.”

Inc. magazine reports:

Health-Care Costs Easing
Workplace wellness programs may be reining in rising costs, a survey finds.
From: Inc.com | August 13, 2008 By: Michael Gadd

Employer health-care costs are expected to rise at a slower pace in the year ahead, as more workplaces offer wellness programs and consumer-driven coverage options, according to Aon Consulting.

Based on a survey of more than 70 health-care insurers, the Chicago-based consulting firm estimates that that health-care costs will increase by 10.6 percent over the next 12 months, a 0.3 percent drop from last year and the lowest rate since the study was launched in 2001.

Rising prescription drug costs are also expected to ease, dropping by 0.3 percent for last year to 9.2 percent.

The study attributes the lower costs to an upturn in workplace wellness programs and consumer-driven coverage.

According to John Zern, the firm’s health and benefits director, employers could be doing more to combat rising health-care costs, in addition to wellness programs.

“This includes greater senior management support for these programs, better employee communications and more consistent cooperation from the medical community,” he said in a statement.

Welcome to Medical Care .org. We hope to provide patients with resources and guidance to find specialists who provide health care in the following specialties (and more!):

• Allergy & Immunology - Allergic and immunologic diseases and their respiratory complications (such as pollen, chemical and food allergies, asthma and AIDS).
• Anesthesia - Anesthesia or relief of pain during surgery and childbirth, and control of paid due to various causes.
• Cardiovascular Disease - Cardiology diseases of the heart and blood vessels.
• Dermatology - Diseases of the skin.
• Emergency Medicine - Diseases that are acute medical or surgical conditions or injuries that require urgent or immediate care (usually in a hospital emergency room).
• Endocrinology and Metabolism - Diseases of the internal glands of the body, including diabetes mellitus.
• Family Practice - All diseases and related total health care of an individual and the family.
• Gastroenterology - Diseases of the digestive tract, including the stomach, bowel, liver and pancreas.
• General Practice - All diseases and related total health care of an individual and the family.
• Geriatric Medicine - Diseases of the elderly.
• Gynecology - See “Obstetrics and Gynecology”.
• Gynecologic Oncology - Cancer diseases of the female reproductive system.
• Hematology - Disorders of the blood and blood-forming organs (including cancerous disorders of the blood) such as anemia, leukemia and lymphoma (see Oncology, Medical).
• Infectious Diseases - Infections of all types.
• Internal Medicine - All diseases and total health care of adults, usually 18 years of age and older.
• Neonatology - Disease of the newborn child.
• Nephrology - Diseases of the kidney, including dialysis.
• Neurology - Diseases of the brain, spinal cord, nervous system and related structures.
• Neurological Surgery - Diseases of the brain, spinal cord, nervous system and related structures requiring surgery.
• Obstetrics and Gynecology - Normal and abnormal pregnancy, diseases of the female reproductive system and fertility disorders.
• Oncology, Medical - Cancer and disorders of the blood and blood-forming organs (see Hematology).
• Ophthalmology - Diseases of the eye.
• Orthopedic Surgery - Diseases of the bones, joints, muscles and tendons.
• Otorhinolaryngology - Ear, Nose & Throat - Diseases of the ears, nose, sinuses, throat and upper airway passages.
• Pathology - Tissues and specimens removed by biopsy and surgery to diagnose normal from diseased tissues and specimens; supervises and interprets laboratory tests on blood, urine and other body fluids.
• Pediatrics - All diseases and total health care of newborns, infants, children and adolescents.
• Physical Medicine and Rehabilitation - Diseases with major and minor disabilities requiring restoration of functional ability such as assistance, retraining and recondition of muscles, tendons and extremities for ambulation and other activities of daily living.
• Plastic Surgery - Diseases and conditions requiring surgical reconstruction for deformity or loss of a body part, or for cosmetic purposes to improve appearance or function.
• Podiatric Medicine - Podiatry - Disease of the foot and ankle as they affect the conditions of the feet.
• Preventative Medicine - Health care and other measures to avoid delay or prevent disease or illness from occurring.
• Psychiatry - Diseases affecting mental health including diseases of the brain, nervous system and substance abuse of drugs or chemicals.
• Pulmonary Disease - Diseases of the lung.
• Radiology, Diagnostic - X-ray, ultrasound and other imaging techniques such as Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI).
• Radiology, Nuclear - Diseases requiring use of radioactive isotopes or as an aid in diagnosis and/or therapy.
• Radiation Oncology - Cancer and other diseases with x-ray therapy, radioactive isotopes and linear accelerator particle radiation.
• Rheumatology - Diseases of the joints including arthritis and autoimmune diseases.
• Sports Medicine - Diseases and injuries acquired in sports.
• Surgery, General - Disease that require surgical operation for diagnosis or treatment.
• Surgery, Hand - Diseases and injuries of the nerves, tendons, muscles, bones or skin of the hand requiring surgery.
• Surgery, Thoracic - Diseases of the chest, including lungs, heart, blood vessels and chest wall, that require surgical operation for diagnosis and/or treatment.
• Surgery, Vascular - Diseases of the blood vessels that require surgical operation for diagnosis or treatment.
• Surgery, Colon and Rectal - Diseases of the large intestine (bowel), rectum and anus that require surgical operation for diagnosis or treatment.
• Surgery, Urology - Diseases of the kidneys, bladder and male reproductive tract that require surgical operation.